DuBois, PA · Clearfield County
Statement Continuation
This continuation form gives people providing a statement to the DuBois City Police Department space to add their name, incident number, and written details.
What this form is
The Statement Continuation form provides lined space for additional written details, with fields for the person's name and incident number. It is for use when more room is needed to continue a statement for the DuBois City Police Department. The form includes a signature line and a warning about unsworn falsification to authorities under Section 4904 of the PA Crimes Code.
Who needs it
A person providing a statement to the DuBois City Police Department may use this form when they need additional space to write.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; it warns about unsworn falsification to authorities, and the signer signs the continuation statement.
How to submit this form
- 1
Download The Form
Download the Statement Continuation PDF.
- 2
Complete The Form
Enter your name and incident number, then write the additional statement details on the lines provided.
- 3
Review And Sign
Review the warning about unsworn falsification to authorities, then sign the form.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the DuBois Statement Continuation form for?
- It provides lined space for written details, along with fields for a name and incident number, to continue a statement for the DuBois City Police Department.
- Do I need a notary for the Statement Continuation form?
- No. This document is signed without a notary; it warns about unsworn falsification to authorities, and the signer signs the continuation statement.
- How do I submit the Statement Continuation form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.